Trial sites

Uganda FEAST Trial Coordinating Centre

Malaria Consortium Africa, Kampala

The Malaria Consortium Africa is internationally recognized for its work on communicable disease control and complementary health systems strengthening in Africa and Asia. The communicable diseases the Malaria Consortium works on include malaria, TB, diarrhoeal

diseases and neglected diseases. The focus of activities is on the implementation of new approaches, developing local capacity and scaling-up effective interventions. It offers high quality, technically sound and independent support to populations under threat from malaria and other communicable diseases. It works to deliver cost-effective interventions efficiently and on a large scale, with a special focus on poor and difficult to reach communities. MCA undertakes independent evaluations of global, regional and local health initiatives and promotes strengthening of regional and local organisations.

FEAST trial Capacity building objectives for Uganda

To conduct courses and bedside teaching to assist with the recognition and management of the sick or critically ill child. This is one of the major objectives of the site preparation and will consist of an on site taught course ETAT (Emergency Triage and Treatment) as well as bedside teaching courses by a consultant paeditrician. We aim to target personnel at every level of the care pathway in the child’s treatment.

To provide a framework for implementation and evaluation of current guidelines for severely ill children- these can be updated with changes of national or international guidelines.

To assist with clinical trials methodology training, including Good Clinical Practice and long distance taught courses.

To indirectly provide reliable hospital data on the burden of severe disease in childhood including severe falciparum malaria- which may be important for future health planning and evaluation of malaria control measures.

To integrate dedicated trial teams and assimilate trial participant care within the care of other patients on the ward.

Photos Coordinating Centre staff

Dr J TibenderanaDr Lilian Akello

Madina Kalembe

Moses Waweru

FEAST Monitors Gilbert( Left) and Moses(right)

Mbale Regional Referral Hospital

General Information

Mbale Regional Referral Hospital is designated to serve 11 districts in the sub region, but often serves patients from Soroti and Karamoja as well. It is a teaching hospital for Clinical Officers and soon will be upgraded to become a University teaching hospital training medical officers and graduate nurses.

Location

Mbale Regional Referral Hospital is the heart of Mbale Municipal Council and is located in the eastern region of Uganda, 240 km east of Kampala.

Paediatric Facilities

The department of Paediatrics and Child Health, Mbale Regional Referral Hospital (MRRH) in Mbale district is a regional hospital serving the district and its environs. It has a bed capacity of 90 beds and serves as a paediatric referral centre for the eleven districts in the eastern region of Uganda.

Child health services were started in 1924 when the hospital was established, and the full fledged department of Paediatrics and Child Health started in the late 1960s. To date the department offers general as well as specialized services in child health, training for clinical officers, intern doctors and in-service training sessions for almost all cadres of health workers.

On the clinical front, the department has one general ward, one acute care unit and two specialized wards namely the nutrition unit and the Masaba wing paediatrics ward (private ward). It also operates a daily outpatient clinic and two specialized clinics per week in a dedicated outpatient department. The special clinic in children’s ward 3 is run once a week on Wednesdays in the morning hours while the special clinic in the private wing is run on Wednesday afternoons.

The department consists of two paediatricians, one medical officer and one public health specialist who also doubles as a clinician. Two clinical officers are attached to the outpatient department. In this huge department, there are only 18 nurses. The paediatric wing also houses a simple laboratory for basic laboratory tests.

The total patient number admitted and treated in the department varies from year to year, but an average of 12,000 patients (range in the last 5 years being 10,000 to 19,000). All the medical services offered in the department are free of charge.

Training of clinical officers takes place yearly. On average, 400 students go through the department for both pre-clinical and clinical year studies. postgraduate students and organizations.

Mission Statement

"To provide general and specialised health services to the catchment area for improved quality of life."

Photos: Mbale

Mulago: Makerere University and Mulago Hospital National Referral Hospital

General Information

Mulago Hospital is the National referral Hospital in Uganda and teaching hospital for Makerere University with a bed capacity of 1500.

Location

Mulago hospital is located in Kampala, central Uganda.

Paediatric Facilities

The department of Paediatrics and Child Health, Makerere University Medical School, Mulago Hospital, Kampala, is part of Makerere University and Mulago Hospital National referral Hospital, Kampala, Uganda. The department was established in 1956 and is engaged in service delivery, training of medical students (both undergraduates and post graduates) and research. The department has four general wards and 3 specialised units including, a nutritional ward, special care unit and the acute care unit. In addition to the inpatient care the department also runs several general and specialised outpatient clinics throughout the week. There are 34 paediatricians and several other health workers including Medical and clinical officers, various cadres of nursing staffs, laboratory and other paramedical staffs. Over 20,000 patients a year are admitted and treated through the various wards in the department and about 200 undergraduate and 45 post graduate students go through the department each year. Most of the clinical services provided by the department are free of charge to the patients in accordance with the government policy of no cost sharing in public hospitals.

Mission Statement

The mission of the department is to become a centre of excellence in service delivery, training and research in Uganda and the region.

Photos: Mulago

Soroti Regional Referral Hospital

General Information

Soroti Regional Referral Hospital is the main government referral facility for the mid – eastern region of Uganda with a bed capacity of 274 with 64 beds allocated to the paediatric unit. It serves 6 districts namely: Soroti, Katakwi, Kaberamaido, Amuria, Kumi and Bukedea.
Total annual admissions average 6,000 and overall mortatility rate is 4.1% as of 2008.

Location

Soroti Regional Referral Hospital is situated 320 Km North East of Kampala.

Paediatric Facilities

The department of Paediatrics and Child Health consists of one general wards and one nutritional ward. There are 3 paediatricians and a limited number of dedicated medical and nursing staff, including interns and clinical officers and various cadres of nursing staff. Over 7,000 children are treated in the general ward each year. Most of the clinical services provided by the department are free of charge to the patients in accordance with the government policy of no cost sharing in public hospitals.

Mission Statement

"To provide general and specialized health services to the people of Soroti regional referral hospital catchment area for improved quality of life."

Paediatric facilities

Mission statement

The mission of the hospital is to provide health care to the needy and fight diseases and poverty, thus witnessing the maternal concern of the church for every sick person regardless of ethnic origin, social status, religious or political affiliation. The hospital wants to promote access to health care of the weakest social groups like women, children, people in destitute financial conditions, and people affected by chronic diseases and unable to provide for themselves offering to all of them a quality medical service. The hospital advocates a comprehensive, integrated and sustainable action on health, which includes treatment, prevention and training of health workers. In fulfilling its mandate the hospital shall always follow the medical ethics and moral teaching of the Roman Catholic Church (RCC) and shall follow the mission statement and policy of the catholic health services in Uganda, as approved by the Bishops’ conference in June 1999. The hospital will deliver its services in accordance with the stated policies and directives of the ministry of health.

Lacor FEAST Team Members

Dr. Richard NyekoBenedict OtiiPaska Lanyero

Photos: Lacor

Teule Hospital, Muheza

General Information

Teule Hospital is a 330 bed capacity district hospital located in Muheza. It is an Anglican church hospital but designated by the government as the district hospital for Muheza district. The hospital supplies medical services to a population of about 280, 000 covering an area of 100km by 50 km.

Geographical location

Muheza is a small district town in the North East of Tanzania 40 Kms inland from the port of Tanga and about 100 kms south of the Kenyan border. It lies at the foot of the East Usambara Mountains on the edge of the coastal plain.

Paediatric Facilities

Services offered include: General inpatient care, malnutrition care programme, neonatal care, HIV and TB care. There are two wards/specialized units, each having a 35bed capacity, a neonatal unit with 3 beds, and dependent unit with 5 beds. Research is conducted at the Hills ward, one of the two paediatric wards. Admission numbers ranges between 3500-6000 admissions/year.

Vision statement

To provide a centre of excellence in all aspects of patient care, a good environment for patients and staff, and to strive continually for higher standards. To reach these goals we are grateful to our glorious Lord Jesus Christ whose example in love and service we try to follow.

KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya

The Wellcome Trust Major Overseas Programme in East Africa is centred in Kenya, and conducts work in Kenya and a number of surrounding countries. It began in 1989 as a series of projects involving three major stakeholders: KEMRI, Oxford University and the Wellcome Trust. Over twenty years it has grown from a total staff of 15 to one of over 600 and is one of the most productive research programmes in Africa. The central aim of the programme is to conduct research to the highest international scientific and ethical standards on the major causes of morbidity and mortality in the region.

The research model has developed to one of undertaking detailed clinical descriptions and linking these with epidemiological studies. These studies lead to further detailed pathophysiological and clinical work, generating testable hypotheses of conditions that are common in Africa. These hypotheses are tested in smaller ‘proof of principle’ trials, before being tested in large definitive trials that will provide firm evidence for the management of common conditions. The underlying ethos is to conduct research that can be applied to health facilities in the remainder of Africa and will influence public health policy.

The Clinical Research Cluster

The clinical unit has played a central role in the development of the overall research programme in Kenya over the last 15 years. Our location in a busy district hospital provides a unique opportunity to define and optimise management of major causes of morbidity and mortality presenting to health services in a malaria endemic area. Data from numerous clinical studies have fed into National and WHO guidelines on the management of malaria and other common childhood illnesses. Key components of the current clinical program include the standardization of the admission management through protocol directed therapy for the leading causes of hospital admission (eg: malaria, respiratory tract infection, malnutrition and neonatal sepsis) and the development of uniform admission process guided by a proforma. These have allowed comprehensive description and identification of prognostic factors for the core childhood syndromes, as well as identifying emerging diseases (esp HIV) and generated a number of research studies aimed at validating current (WHO) recommendations. In April 2002 online data entry of ward admission, linking these events has proved a powerful tool in describing community incidence of hospital admission for a range of conditions.